Do maternal characteristics and past pregnancy experiences predict preterm delivery among women aged 20 to 34?

OBJECTIVE: To identify key demographic, lifestyle, and medical indicators for preterm births in women aged 20 to 34. METHODS: A population-based, case-control study consisting of 987 women aged 20 to 34, who delivered a liveborn singleton infant at <37 weeks' gestation in Alberta between May 1999 and August 2000. Controls delivered liveborn infant(s) at > or =37 weeks' gestation. Information was obtained from computer-assisted telephone interviews, and the provincial Physician Notice of Stillbirth/Birth database. Analysis included bivariate and logistic regression techniques. RESULTS: Logistic regression modelling indicated that significant risk factors for preterm delivery included poor past pregnancy outcome (odds ratio [OR] 6.4), poor emotional health (OR 1.8), more than 3 years or less than 1 year between pregnancies (OR 1.4 and 1.9, respectively), polyhydramnios and oligohydramnios (OR 4.1), bleeding at greater than 20 weeks' gestation (OR 10.4), malpresentation (OR 2.9), gestational hyper- tension (OR 2.2), and gestational hypertension with proteinuria (OR 4.4). Women who had fewer than 10 prenatal visits, regardless of attending prenatal classes, were at highest risk of preterm delivery (OR 6.7). CONCLUSIONS: In this population of women aged 20 to 34 years, few prenatal visits, poor emotional health prior to pregnancy, and conditions of the current pregnancy were strongly associated with preterm singleton birth.

The relationship between self-reported emotional health, demographics, and perceived satisfaction with prenatal care.

Aims to describe pregnant women with poor emotional health and the relationship between self-reported emotional health and prenatal care satisfaction. To this end, 1,265 women who delivered a live-born singleton infant were interviewed and information abstracted from prenatal records. Concludes that patient assessment of satisfaction with prenatal care may be related to both self-reported emotional health and delivery of medical care. Identifying and addressing emotional health of prenatal patients may improve compliance with medical recommendations, ultimately improving health outcomes.

The content of prenatal care and its relationship to preterm birth in Alberta, Canada.

Prenatal care is universally acknowledged as the hallmark of preventive care for pregnant women, and it is commonly assumed to have a positive influence on birth outcomes. The results of studies that have examined the impact of prenatal care on adverse birth outcomes, however, have been equivocal. These investigations have focused primarily on initiation of prenatal care and its timing, and not on the content of care received. Using data obtained from maternal self-reports and an electronic perinatal database, we examined the relationship between selected components of prenatal care (i.e., medical management, health education, and health advice) and the birth of a preterm infant. We found that health care providers are meeting the clinical guidelines for the medical management of pregnancy, but they are not adequately meeting pregnant women's needs for health education and advice. We found no association between the content of prenatal care and the birth of a preterm infant. Prenatal care must focus more on providing health education and advice to pregnant women.